Polycystic Ovary Syndrome and Psychotic Disorder

Abstract

Polycystic ovary syndrome (PCOS), a disease that usually emerges during adolescence, is characterized by hormonal imbalance and ovarian dysfunction. The prevalence can vary between 5.6 to 21.3% in women and 6% in adolescent girls. This discrepancy is related to the population studied and the diagnostic criteria used. The underlying pathophysiology of PCOS is not fully understood, but it can lead to a number of co-morbidities, including hypertension, diabetes, dyslipidemia, and also, mental health disorders. Clinical and preclinical data indicate neuroendocrine involvement with dysfunction in gamma-Aminobutyric acid (GABA) signaling and neuronal androgen receptors that might reduce hypothalamic sensitivity and lead to an impairment of estradiol and progesterone feedback. Based on these assumptions, the aims of this paper are to review the association of PCOS and psychotic disorders in order to address the burden of women comorbid for both conditions.

Prevalence and associated risk factors for mental health problems among patients with polycystic ovary syndrome in Bangladesh: A nationwide cross—Sectional study

“…One earlier meta-analysis reported that the prevalence of depression and anxiety were 36.6% and 41.9% among women suffering from PCOS [ 57 ]. It can be concluded that PCOS and its consequences are responsible for increased mental health problems of women suffering from this hormonal disease [ 58 , 59 ]. The PCOS cases are increasing in Bangladesh over the last decades due to the changed lifestyle and some other demographic factors.…”

The effect of polycystic ovarian syndrome on the mental health of women of reproductive age

“…13,14 Generally, the condition usually begins during puberty but doesn't usually get diagnosed until later years when the condition has significantly progressed. 15 There are currently three sets of criteria for diagnosing PCOS stipulated by the US National Institutes of Health (NIH), the Rotterdam criteria, and the androgen excess society (AES). 10 Although they have slight differences, all criteria agree that oligo-or anovulation and hyperandrogenism should be present for diagnosis as well as the exclusion of other endocrine disorders.…”

“…13 The prevalent theory behind the pathophysiology of PCOS is that ovarian dysfunction and hyperandrogenism is due to a defect in the feedback loop of the steroid-hormone gonadotropin-releasing hormone (GnRH). 15 The patients with the syndrome have an increased pulsatile GnRH secretion which causes increased LH pulse frequency, pulse amplitude and increased luteinizing hormone (LH)/follicle-stimulating hormone (FSH) ratios. 14 The increase in LH secretion stimulates the theca interna cells to produce androgens causing the increase in male steroid hormones seen in the condition.…”

“…1 The most common of these symptoms are depression and anxiety while others include bipolar disorder, schizophrenia spectrum disorder, eating disorder, personality disorder, sleeping disorder, and psychosis. 15,18,19 The exact pathophysiology of these conditions however is not yet fully understood. 20 Alexithymia, a personality trait characterized with difficulty to identify and distinguish emotions from bodily sensations, difficulty to describe and verbalize emotions, externally oriented thinking style, poverty of fantasy life or imaginative ability, and poor empathy is a risk factor for various physical and mental health problems including anxiety, depression, compulsive or addictive behaviours, physical symptoms, and potentially psychosomatic diseases.…”

Schizophrenia Psychosis in Women

“…Some comorbidities associated with schizophrenia are specific to women, for instance, Turner's syndrome [95] or polycystic ovaries [96]. Some are very much more common in women than in men, for instance, eating disorders, thyroid disease, autoimmune disorders, and fertility disorders [97][98][99][100].…”